Provider Demographics
NPI:1386034643
Name:EMPOWER KIDS, INC.
Entity Type:Organization
Organization Name:EMPOWER KIDS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MENDY
Authorized Official - Middle Name:
Authorized Official - Last Name:BRACH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-762-6699
Mailing Address - Street 1:19 ROBERT PITT DR STE 112
Mailing Address - Street 2:
Mailing Address - City:MONSEY
Mailing Address - State:NY
Mailing Address - Zip Code:10952-5310
Mailing Address - Country:US
Mailing Address - Phone:845-762-6699
Mailing Address - Fax:845-364-6332
Practice Address - Street 1:19 ROBERT PITT DR STE 112
Practice Address - Street 2:
Practice Address - City:MONSEY
Practice Address - State:NY
Practice Address - Zip Code:10952
Practice Address - Country:US
Practice Address - Phone:845-676-2669
Practice Address - Fax:845-364-6332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-26
Last Update Date:2018-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000227-1103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty